E1: "Where do I Start?"

In our first full supervision session, Alex Scott brings a particularly challenging case to the table: a 14-year-old boy navigating persistent low back pain following a traumatic brain injury (TBI) and a complex refugee background.

Alex and James unpack the imposter syndrome that often hits clinicians when faced with high-complexity cases and discuss why traditional pain education isn't always the right first step. We explore the tactical shift from "fixing the pain" to "building a routine" and the importance of meeting a client where they feel most empowered.

In this episode, we discuss:

• The case study: Navigating TBI, PTSD, and persistent pain in a pediatric community setting.
• The approach: Why Alex chose to prioritise the client’s goal of bulking up over traditional Pilates or core exercises.
• Trauma-informed care: Practical applications of the five pillars: Safety, Choice, Empowerment, Trustworthiness, and Collaboration.
• The evidence base: What recent Cochrane reviews say about exercise types for non-specific low back pain (Hint: there’s no magic exercise).
• Clinical realities: An honest reflection on what worked and what didn't, the importance of clinician gender in rapport and knowing when a case is beyond your direct scope.

Resources mentioned

• What is Trauma Informed Care - ACI
• Exercise for treatment of chronic low back pain - Cochrane Review 2021
• Trauma and Pain - NIH 2021

Any questions, comments or requests?

Your direct line to Alex and James is [e-mail]